SCORING OF PAIN PERCEPTION DURING PHACOEMULSIFICATION UNDER TOPICAL ANAESTHESIA

Authors

  • Mohammad Aamir Khan Women Medical College
  • Bushra Aaqil Ayub Medical College
  • Zainab Nazneen Ayub Medical College
  • Afsheen Faisal Ayub Medical College
  • Zarrin Siddiqi Akhtar Saeed Medical College
  • Riffat Latif Ayub Medical College

Abstract

Background: Topical anaesthesia is safe and inexpensive type of anaesthesia used during phacoemulsification as compared to local anaesthesia. The trend of conducting surgeries under topical anaesthesia is increasing globally. The objective of this study was to determine the perception of severity of pain during phacoemulsification using topical anaesthesia. Methods: This descriptive cross-sectional study was conducted at Jinnah International Hospital Abbottabad for a period of one year and included 196 patients of posterior subcapsular cataracts. Data was collected on a pretested structured questionnaire and analysed by SPSS version 20. Chi square test was used to find association between variables and p-value of equal or less than 0.05 was considered significant. Results: The mean age of the patients was 60.43±14.63 years. Out of 196 patients, 110 (56.1%) were males and 86 (43.9%) were females. During surgery pain score was 0 (no pain) in 149 (76%), 1 (mild) in 14 (7.1%), 2 (moderate) in 15 (7.7%) and 3 (severe) in 18 (9.2%) patients. Pain score was found to be significantly associated with gender (p=0.003) and age group (p=0.008). Conclusion: Phacoemulsification can be safely performed under topical anaesthesia in patients with posterior subcapsular cataracts with minimum intraoperative pain perception by the patients.

Author Biographies

Mohammad Aamir Khan, Women Medical College

Department of Ophthalmology

Bushra Aaqil, Ayub Medical College

Department of Ophthalmology

Zainab Nazneen, Ayub Medical College

Department of Community Medicine

Afsheen Faisal, Ayub Medical College

Department of Pharmacology

Zarrin Siddiqi, Akhtar Saeed Medical College

Department of Anatomy

Riffat Latif, Ayub Medical College

Department of Anaesthesia

References

Gupta VB. Etiopathogenesis of cataract, an appraisal. Indian J Ophthalmol 2014;62(2):103–10.

Davis G. The evolution of cataract surgery. Mo Med 2016;113(1):58–62.

Parihar J, Sahoo PK, Dash RG, Kamath AP. An advanced cataract surgery by Phacoemulsification: an initial experience. Med J Armed Forces India 2017;54(3):229–31.

Allen D, Vasavada A. Cataract and surgery for cataract. BMJ 2006;333(7559):128–32.

Mehta R, Punjabi S, Bedi N, Nagar CK. Comparison of peribulbar anesthesia and topical anesthesia on outcome of phacoemulsification. Int J Res Med Sci 2017;5(6):2608–11.

Reddy SC, Thevi T. Local Anaesthesia in Cataract Surgery. Int J Ophthalmic Res 2017;3(1):204–10.

Tavares VN, Colossi CG, Saalfeld V, Vilela MAP. Phacoemulsification under topical anaesthesia: series of cases. Rev Bras Oftalmol 2013;72(3):178–80.

Syed Z, Malik TM, Malik AM, Khan DA, Ejaz U, Farooq A. Peribulbar versus topical anaesthesia for cataract surgery; patient’s satisfaction. Pak J Ophthalmol 2014;30:63–7.

Gombos K, Németh J. Comparing retrobulbar and topical anaesthesia in cataract surgery by phacoemulsification- How can patient comfort during surgery by phacoemulsification be improved? Eur Ophthalmic Rev 2009;3(1):42–4.

Medscape. Topical anaesthesia. [Internet]. [cited 2019 Sep 25]. Available from: https://reference.medscape.com/article/109673-overview

Kumar M, Chawla R, Goyal M. Topical anesthesia. J Anaesthesiol Clin Pharmacol 2015;31(4):450–6.

Vision Aware. Are there different types of cataracts? [Internet]. [cited 2019 Sep 25]. Available from: https://www.visionaware.org/info/your-eye-condition/cataracts/different-types-of-cataracts/125

Apil A, Kartal B, Ekinci M, Cagatay HH, Keles S, Ceylan E, et al. Topical Anesthesia for Cataract Surgery: The Patients' Perspective. Pain Res Treat 2014;2014:827659.

Chaudhry TA, Aqil A, Aziz K, Javed AA, Tauqir MZ, Ahmad K. Patients’ visual experience during phacoemulsification cataract surgery and associated fear. BMC Res Notes 2014;7:663.

Ermisº SS, Öztürk F, Inan UU. Comparing the efficacy and safety of phacoemulsification in white mature and other types of senile cataracts. Br J Ophthalmol 2003;87(11):1356–9.

Rand WJ, Stein SC, Velazquez GE. Rand-Stein analgesia protocol for cataract surgery. Ophthalmology 2000;107(5):889–95.

Walsh A, Pine AP, Junior Lamb A, Cream AS. Oculocardial reflex in phacoemulsification. Topical anesthesia x peribulbar anesthesia. Rev Bras Oftalmol 2000;59(10):731–5.

Tan CS, Fam HB, Heng WJ, Lee HM, Saw SM, Au Eong KG. Analgesic effect of supplemental intracameral lidocaine during phacoemulsification under topical anaesthesia: a randomised controlled trial. Br J Ophthalmol 2011;95(6):837–41.

Haripriya A, Chang DF, Reena M, Shekhar M. Complications rates of phacoemusification and manual small incision cataract surgery at Aravind Eye Hospital. J Cataract Refract Surg 2012;38(8):1360–9.

Alam M, Mohammad L, Idrees M. Analysis of Four Point Score Scale for Pain Assessment in Phacoemulsification under Topical Anesthesia - Proparacaine. Ophthalmol Update 2018;2(16):582–4.

Ahmed S. Cataract Surgery: Is it Time to Convert to Topical Anaesthesia? Pak J Ophthalmol 2008;2(24):62–7.

Javed EA. Phacoemulsification under topical anesthesia alone versus topical anesthesia with subconjunctival infiltration of 2% lignocaine. Pak J Ophthalmol 2010;26(2):91–5.

Syed Z, Malik TM, Malik AM, Khan DA, Ejaz U, Farooq A. Peribulbar Versus Topical Anesthesia for Cataract Surgery; Patient’s Satisfaction. Pak J Ophthalmol 2014,2(30):63–7.

Monestam E, Kuusik M, Wachtmeister L. Topical anaesthesia for cataract surgery: a population based perspective. J Cataract Refract Surg 2001;27(3):445–51.

Gombos K, Jakubovits E, Kolos A, Salacz G, Németh J. Cataract surgery anaesthesia: is topical anaesthesia really better than retrobulbar? Acta Ophthalmol Scand 2007;85:309–16.

Published

2021-10-11

Issue

Vol. 33 No. 4 (2021): Journal of Ayub Medical College Abbottabad

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.